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A pressure ulcer prevention program at University Hospitals Coventry and Warwickshire Trust in the U.K. includes intensive training and the use of social media to engage staff and keep them up to date on prevention strategies. The ongoing program features an analysis and reporting system, an inventory of pressure-relieving devices, consistent messaging to staff and reviews of staff education. The health system has nearly eliminated avoidable pressure ulcers since April 2012, with one grade 3 and two grade 2 ulcers recorded in February.

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Hospital leaders who once accepted pressure ulcers as a natural complication of long-term stays have successfully reduced the rate of pressure ulcers with vigorous prevention programs. Crouse Hospital in Syracuse, N.Y., for example, installed pressure-relieving beds, educates staff to detect early signs of pressure ulcers, requires daily skin assessments and assigns a team of wound ostomy nurses to high-risk patients. Sonora Regional Medical Center in California implemented a program of skin inspections every 12 hours or at the start of each shift and uses special elastic stockings and cold pads to prevent irritation from developing into an ulcer.

The James Lind Alliance Pressure Ulcer Priority Setting Partnership issued a list of 12 priorities for further study in preventing and treating pressure ulcers. Research should investigate the efficacy of topical products, surgical interventions, repositioning and pressure-relieving devices; the effects of medical staff education; and the effects of diet and hydration, among other areas, the group said.

Researchers have designed a skin-graft adhesive containing microneedles that swell when exposed to moisture. The swelling action is reversible, causes only minimal damage to soft tissue and can be removed with less trauma than staples, the researchers said. The adhesive is based on the spiny-headed worm Pomphorhynchus laevis, which attaches to its host's intestinal wall by puncturing it with a spine, then inflating its head inside the tissue.

Certified wound specialist Desmond Bell provides guidance for clinicians who want to develop an interdisciplinary, community-based wound-care team. Clinicians must be aware of the importance of time in wound treatment, the team must consistently follow programs and protocols, and the clinic should have a well-considered social media presence, Bell writes. An electronic health record system can help ensure compliance and proper billing, and providers should network and volunteer in the community, he suggests.

Suzy Scott, a nurse at the Memphis Veterans Medical Center, has received attention for her research into preventing bedsores, in advance of Medicare's decision not to reimburse hospitals for treating preventable problems. Scott found that the pressure ulcers were more common in surgery patients, but the incidence was cut when a special pressure-relieving pad was used during surgery.